Injuria cerebral secundaria en UCI: ¿cómo la atención del equipo de salud modifica los eventos clínicos que la causan?

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dc.contributor.advisorAmaya Rey, Maria Consuelospa
dc.contributor.advisorSoto Lesmes, Virginiaspa
dc.contributor.authorOrtega Pérez, Stefany Rossesspa
dc.contributor.researchgroupCuidado y Práctica en enfermería, salud familiar enfermería familiar y medicion en saludspa
dc.date.accessioned2020-08-20T14:27:13Zspa
dc.date.available2020-08-20T14:27:13Zspa
dc.date.issued2020-06-23spa
dc.description.abstractIntroducción: El principio fundamental en el tratamiento global de la lesión cerebral es evitar las injurias secundarias. Una variedad de intervenciones realizadas por el equipo de salud puede estimular al paciente neurocrítico y conducir a las condiciones que causan injuria cerebral secundaria (ICS). Objetivos: el objetivo principal de este estudio fue determinar la magnitud de los cambios de los eventos clínicos causantes de injuria cerebral secundaria inducidos por la atención del equipo de salud a pacientes con enfermedad cerebrovascular o trauma craneoencefalico. Metodología: este estudio tiene un diseño cuantitativo observacional longitudinal. Se analizaron 144 observaciones de tres procedimientos: baño en cama, aspiración de secreciones y cambio de posición. En cada una de ellas se registraron las variables fisiológicas de tensión arterial sistólica (TAS), tensión arterial diastólica (TAD), tensión arterial media (TAM), frecuencia cardíaca (FC), frecuencia respiratoria (FR) y saturación de oxígeno (SPO2) en cuatro momentos: M1 al iniciar la intervención, M2 al finalizar, M3 a los 5 minutos de haber finalizado y M4 a los 10 minutos de haber finalizado. La magnitud de los cambios pudo ser calculada utilizando la prueba de Friedman y con una comparación dos a dos con la prueba de rangos con signo de Wilcoxon. Resultados: los eventos injuriantes relacionados con la atención del equipo de salud ocurrienron en menos del 50% de las intervenciones. El evento injuriante más frecuente en las intervenciones fue la TAS >160 mmHg, seguida de la TAM >110 mmHg y la FC >100 lat/min. La intervención que más produjo eventos injuriantes en fue el baño en cama (158); sin embargo, al analizar por momentos, se observa que el porcentaje de aumento de M1 a M2 fue mayor en la aspiración de secreciones (27% en TAS, 31% en TAM y 17% en FC), lo que indica que se generaron más eventos injuriantes nuevos a causa de la aspiración de secreciones. Conclusión: Las intervenciones en los pacientes neurocríticos deben realizarse de una manera que minimice la aparición de eventos injuriantes y así reducir la exacerbación de la ICS (Texto tomado de la fuente).spa
dc.description.abstractBackground: The main goal of the treatment of brain injury is to avoid secondary injuries. A variety of health care team interventions can stimulate the neurocritical patient and lead to conditions that cause secondary brain injury (SBI). Objetives: The aim of this study was to determine the magnitude of changes in clinical events causing secondary brain injury related to interventions in patients with cerebrovascular disease or traumatic brain injury. Methods: This study had a quantitative longitudinal observational design. A total of 144 observations in 48 patients were analysed. In each of them, physiological variables systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), heart rate (HR), respiratory rate (RF) and oxygen saturation (SatO2) were recorded at four moments: M1 at the start, M2 at the end, M3 5 minutes and M4 10 minutes after the end. The magnitude of the changes could be calculated using the Friedman test. Subsequently, a two-to-two comparison was made with the Wilcoxon sign rank test. Results: secondary insults occurred in less than 50% of the interventions. The most frequent secondary insult was SBP >160 mmHg, followed by MBP >110 mmHg and HR >100 lat/min. The intervention that produced the most secondary insult was bed bathing (158); however, analyzed by time, it is observed that the percentage of increase from M1 to M2 was greater in suctioning interventions (27% in SBP, 31% in MBPand 17% in HR), indicating that more new injurious events were generated by aspiration of secretions. Conclusions: Interventions in neurocritical patients should be conducted in a manner that minimizes the occurrence of secondary insults and thus reduces the exacerbation of SBI.eng
dc.description.additionalLínea de investigación: Cuidado y Práctica en Enfermería: Salud Familiar, Enfermería Familiar, Medición en Saludspa
dc.description.degreelevelDoctoradospa
dc.format.extent177spa
dc.format.mimetypeapplication/pdfspa
dc.identifier.urihttps://repositorio.unal.edu.co/handle/unal/78108
dc.language.isospaspa
dc.publisher.branchUniversidad Nacional de Colombia - Sede Bogotáspa
dc.publisher.programBogotá - Enfermería - Doctorado en Enfermeríaspa
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dc.rightsDerechos reservados - Universidad Nacional de Colombiaspa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.licenseAtribución-NoComercial 4.0 Internacionalspa
dc.rights.spaAcceso abiertospa
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/spa
dc.subject.ddc610 - Medicina y salud::616 - Enfermedadesspa
dc.subject.proposalInjuria cerebral secundariaspa
dc.subject.proposalSecondary brain injuryeng
dc.subject.proposalEventos injuriantesspa
dc.subject.proposalSecondary insultseng
dc.subject.proposalNursing interventionseng
dc.subject.proposalIntervenciones de enfermeríaspa
dc.subject.proposalStrokeeng
dc.subject.proposalEnfermedad Cerebrovascularspa
dc.subject.proposalTraumatic brain injuryeng
dc.subject.proposalTrauma craneoencefálicospa
dc.subject.proposalICUeng
dc.subject.proposalUCIspa
dc.titleInjuria cerebral secundaria en UCI: ¿cómo la atención del equipo de salud modifica los eventos clínicos que la causan?spa
dc.typeTrabajo de grado - Doctoradospa
dc.type.coarhttp://purl.org/coar/resource_type/c_db06spa
dc.type.coarversionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/doctoralThesisspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2spa

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